Fludarabine monophosphate

Hurst PG, Habib MP, Garewal H, Bluesteiu M, Paquin M, Greenberg BR. Pulmonary toxicity associated with fludarabine monophosphate. Invest New Drugs 1987 5(2) 207-10. 

Fludarabine monophosphate (FAMP) is an analog of the purine adenine. Like cytarabine, fludarabine interferes with DNA polymerase, causing chain termination. Unlike ara-C, fludarabine is also incorporated into RNA, resulting in inhibited transcription. The usual dose-limiting toxicity is myelosuppression. Fludarabine is also immunosuppressive, with associated opportunistic infections. ... 

Fludarabine phosphate (2-fluoro-arabinofuranosyladenine monophosphate) is rapidly dephosphorylated to 2-fluoro-arabinofuranosyladenine and then phosphorylated intracellularly by deoxycytidine kinase to the triphosphate. This metabolite interferes with DNA synthesis through inhibition of DNA polymerase- and ribonucleotide reductase, and it also induces apoptosis. Fludarabine phosphate is used chiefly in the treatment of low-grade non-Hodgkin s lymphoma and chronic lymphocytic leukemia (CLL). Fludarabine phosphate is given parentally and is excreted primarily in the urine its dose-limiting toxicity is myelosuppression. 

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